Alexey N Shkarubo1, Konstantin V Koval1, Ilia V Chernov2, Dmitry N Andreev1, Andrey A Panteleyev3. 1. Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia. 2. Department of Neurooncology, Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russia. Electronic address: ilch@list.ru. 3. Department of Spine Pathology, N.N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
Abstract
INTRODUCTION: With the introduction into the neurosurgical practice of minimally invasive methods using endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. OBJECTIVE: To analyze the results of surgical treatment of patients with various centrally located tumors of the base of the skull that extend into the anterior region of the posterior cranial fossa using the endoscopic endonasal transclival approach. METHODS: The personal surgical experience of the first author is 136 patients with various tumors (e.g., chordomas, meningiomas, pituitary adenomas, and fibrous dysplasia). RESULTS: Radicality of tumor removal was total 61.03%; subtotal 25%; partial 13.23%; and insufficient removal 0.74%. Postoperative cerebrospinal fluid leaks occurred in 9 cases (6.62%) and meningitis in 13 cases (9.56%). In 2 cases, surgical treatment had a lethal outcome (1.47%). CONCLUSIONS: The endoscopic endonasal transclival approach can be used to obtain access to centrally located skull base tumors. This approach allows for a radical and low-risk removal of various skull base tumors of central localization that, until recently, were considered to be almost inoperable.
INTRODUCTION: With the introduction into the neurosurgical practice of minimally invasive methods using endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. OBJECTIVE: To analyze the results of surgical treatment of patients with various centrally located tumors of the base of the skull that extend into the anterior region of the posterior cranial fossa using the endoscopic endonasal transclival approach. METHODS: The personal surgical experience of the first author is 136 patients with various tumors (e.g., chordomas, meningiomas, pituitary adenomas, and fibrous dysplasia). RESULTS: Radicality of tumor removal was total 61.03%; subtotal 25%; partial 13.23%; and insufficient removal 0.74%. Postoperative cerebrospinal fluid leaks occurred in 9 cases (6.62%) and meningitis in 13 cases (9.56%). In 2 cases, surgical treatment had a lethal outcome (1.47%). CONCLUSIONS: The endoscopic endonasal transclival approach can be used to obtain access to centrally located skull base tumors. This approach allows for a radical and low-risk removal of various skull base tumors of central localization that, until recently, were considered to be almost inoperable.
Keywords:
Chordoma of the clivus; Clivus; Endoscopic endonasal surgery of the skull base; Endoscopic endonasal transclival approach; Monitoring of cranial nerves; Posterior cranial fossa; Skull base anatomy
Authors: Birgit Coucke; Laura Van Gerven; Steven De Vleeschouwer; Frank Van Calenbergh; Johannes van Loon; Tom Theys Journal: Neurosurg Rev Date: 2021-09-09 Impact factor: 3.042
Authors: Sergio Torres-Bayona; Nathalia Velasquez; Ana Nakassa; Aldo Eguiluz-Melendez; Vanessa Hernandez; Belen Vega; Hamid Borghei-Razavi; Yeiris Miranda-Acosta; Eric W Wang; Carl H Snyderman; Paul A Gardner Journal: J Neurol Surg B Skull Base Date: 2021-05-17